Population Health Exam 3

Homelessness, Home Health, Occupational Health, Rural Communities, School Nursing

What determines the disability experience?

Condition + environment

What contributes to health disparities?

Poor access, low-quality care, lack of coordination

Most maternal and infant deaths are due to what?

Preventable causes

Leading causes of infant death

Preterm birth, infection, SIDS, congenital defects

Preterm definition

<37 weeks

Low birth weight definition

<5.5 lbs

Risk factors for preterm/LBW

Age <17 or >35, poor prenatal care, low SES, stress, substance use

Key pregnancy teaching

Folic acid, avoid substances, manage illness, vaccines

Leading cause of death in children

Injuries

Common child health issues

Lead poisoning, abuse, infections, chronic disease

Who qualifies for WIC?

Women, infants, children <5

WIC eligibility requirements

Income, residency, nutrition risk

Roles of school nurse

Caregiver, educator, case manager, counselor, advocate

School nurse responsibilities

Screenings, meds, chronic care, documentation

Primary prevention in schools

Vaccines, health education

Secondary prevention in schools

Screenings, abuse detection

Tertiary prevention in schools

IEP, chronic disease management

Typical home health patient

Older adult with chronic illness

Homebound definition

Leaves home with difficulty + only for medical reasons

Requirements for Medicare home health

Provider order, skilled care, homebound, intermittent care

What is OASIS?

Assessment tool that determines payment

Key traits of home health nurse

Independent, flexible, critical thinker, communicator

First visit for home health priority

Safety

Common home care concerns

Abuse, neglect, exploitation, bias, boundaries

Causes of rehospitalization

Poor follow-up, non-adherence, lack of support

What should nurse do if unsafe? Home health

Leave immediately and call 911

Role of occupational health nurse

Prevent injury, promote safety, assess risks

ADA law purpose

Prevents discrimination

IDEA law purpose

Free education + IEP for children with disabilities

What is universal design?

Designing spaces accessible to all from the start

Primary prevention (workplace)

Safety training, PPE use, ergonomics, vaccines

Secondary prevention (workplace)

Screenings: exposure monitoring, early detection

Tertiary prevention (workplace)

Rehab, return to work, chronic disease management, disability accommodations

Poverty definition

Lack of resources to meet basic needs

Poverty risk factors

Job loss, low education, single parenting

Health effects of poverty

Chronic illness, shorter life, ↑ hospitalizations

Types of homelessness

Roofless, houseless, insecure, inadequate housing

Major causes of homelessness

Poverty, violence, mental illness, substance use

Primary prevention (homelessness)

Housing, job support, DV prevention, financial assistance

Secondary (homelessness)

Screenings, Mobile clinics, shelters, rapid rehousing, crisis services

Tertiary (homelessness)

Housing support, mental health care, substance treatment

Nurse roles in homelessness

Advocate, educator, case manager

Biggest rural health issue

Lack of access to care

Rural health risks

Smoking, alcohol, obesity, injuries

Migrant worker risks

Mobility, language barriers, poor housing, pesticides

Why do rural patients delay care?

“Don’t work = don’t get paid”

Who provides most rural care?

Family/friends

Key rural mental health issue

High stigma

Emergency care issue in rural areas

Delayed response → worse outcomes

How to improve rural access

Telehealth, community centers, critical access hospitals

Roofless

living on the street

Houseless

shelters

Insecure housing

couch surfing, temporary

Inadequate housing

unsafe/poor conditions

Disability is defined as what 3 components?

Impairment + activity limitation + participation restriction

What major misconception exists about people with disabilities?

That they are unhealthy

What does ADA cover?

Jobs, transportation, public spaces

What is a “qualified individual” under ADA?

Can perform job with or without accommodations

How much higher is violence risk in people with disabilities?

4x higher

What do people with disabilities need during disasters?

Accessible shelters and communication support

Effects of caregiving on families

Financial strain, emotional stress, physical exhaustion

Examples of public assistance programs

SSI, SSDI, food stamps, housing assistance

Medicare certification period for home health

60 days

What is required before starting home health care?

Face-to-face visit + physician plan of care

How often must Medicare home health be renewed?

Every 60 days

How should a nurse act in a patient’s home?

As a guest—no judgment, maintain professionalism

Why is infection control harder in home care?

Lack of controlled environment

4 HUD categories of homelessness

Literally homeless, at risk, other laws, fleeing violence

% of homeless over age 24

92%

% of homeless that are families

28%

Key domains of SDOH

Economic, education, healthcare, environment, social support

Infant mortality indicates what?

Overall population health

Alcohol use in pregnancy causes what?

Fetal alcohol syndrome

Tobacco use in pregnancy leads to what?

SIDS and poor lung development

Poor dental health in pregnancy is linked to what?

Preeclampsia

What is the teaching for HIV-positive mothers in developed countries?

Avoid breastfeeding

Laws in school health

ADA, IDEA, HIPAA, FERPA

IEP is for what?

Education

504 plan is for what?

Accommodations

IHP is for what?

Health plan

% of providers in rural areas

~10%

Who has the poorest health outcomes?

Migrant workers

What does “access to care” include?

Transportation, insurance, availability, culture, trust

Common occupational hazards in rural workers

Pesticides, machinery injuries, heat illness

IEP vs IHP?

IEP: Education plan for learning disabilities and IHP: Medical care plan for health conditions

Skilled vs custodial care?

Skilled: RN/PT care (wound care, IVs) and Custodial: ADLs (bathing, meals)

Certified vs noncertified home agency?

Certified: Medicare-approved and Noncertified: Private pay

High-risk groups for homelessness?

Men, families with children, minorities, veterans, youth, older adults

Causes of homelessness?

Poverty/unemployment, mental illness, substance use, domestic violence, lack of healthcare/support

What is survival sex?

Sex exchanged for food, shelter, money, protection

Who is most at risk for survival sex?

Youth (especially LGBTQ), women

What is Housing First?

Immediate housing with NO requirements

Rural vs frontier?

Rural: low population, some care and Frontier: very isolated, little/no care

What is HPSA?

Area with not enough healthcare providers

Critical access hospital features?

≤25 beds, ≤96 hr stays, Remote location

Ways to increase rural providers?

Loan repayment, scholarships, incentives, rural training, telehealth

Migrant worker demographics?

Young, Hispanic/Latino, low income, limited education, non-English speaking

Migrant worker health risks?

Pesticides, heat illness, injury, infection, poor nutrition

Long-term effects of poverty on children?

Chronic illness, developmental delays, mental health issues, lower education, poor adult economic stability

Medicare requirements for home care?

Homebound, skilled need, provider order, plan of care, certified agency